We first became aware of methylcobalamin, a form of vitamin B12, for use with ALS several years ago.  Recently, cases have emerged where methylcobalamin is apparently being used successfully for the relief of certain ALS symptoms at proper dosage as an intramuscular injectable.  Because it appears to provide noticeable support toward reducing limb weakness and atrophy for persons with ALS, it's time to share this important information with you.


In the mid-1990's, a respected laboratory at the University of Kyoto (Japan) conducted a very impressive rat study on the use of high dosage methylcobalamin (a form of Vitamin B12) for minimizing muscle wasting and atrophy in limbs as is usually attendant to ALS. They followed that up with a small, but carefully controlled and monitored human study and obtained similar results with ALS patients.  In the years since, a number of persons with ALS have tried Vitamin B12, but usually without any impact. WHY? In examining many of the individual users' experiences, we found some unfortunate lapses:

a) Use of cobalamin (a different B12 isomer with reduced bio-availability) instead of methylcobalamin
b) oral ingestion or sub-lingual ingestion,  which provides less bio-availability, instead of injectable methylcobalamin
c) subcutaneous injection instead of intramuscular injection which is more bio-available
d) substantially lower dosage than originally determined as efficacious by the original and subsequent Japanese studies
e) injected once a week instead of the recommended daily injection
f) not used for a sufficient test period to determine its efficacy which should be a one-month minimum and for up to three months
g) not continuing its usage indefinitely after testing as should be done for maximum benefit.


The following information includes two different study abstracts conducted in Japan 10 years apart with encouraging results.

Muscle Nerve Journal
December 1998
Effect of ultrahigh-dose methylcobalamin on compound muscle action potentials in amyotrophic lateral sclerosis: a double-blind controlled study.

Kaji R, Kodama M, Imamura A, Hashida T, Kohara N, Ishizu M, Inui K, Kimura J. Department of Neurology, Kyoto University School of Medicine, Japan.

To develop a symptomatic treatment for amyotrophic lateral sclerosis, we compared the effects of ultrahigh-dose and low-dose (25 and 0.5 mg/day, intramuscularly, for 14 days) methylcobalamin on averaged compound muscle action potential amplitudes (CMAPs) in a double-blind trial. No significant changes in CMAP amplitude were found in 12 patients who had the low-dose treatment at either 2 or 4 weeks after start of treatment. By contrast, 12 patients assigned to the ultrahigh-dose group demonstrated a significant increase at 4 weeks. This method may provide a clinically useful measure to improve or retard muscle wasting, if a larger extended trial fulfills its promise.

Brain Nerve Journal
October 2007   
Izumi Y, Kaji R, .Department of Clinical Neuroscience, Institute of Health Bioscience, The University of Tokushima, Graduate School, 50-1 Kuramoto-cho, Tokushima 770-8503, Japan.

Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disorder affecting both upper and lower motor neurons. Weakness may begin in the legs, hands, proximal arms, or pharynx. The course is relentless and progressive without remissions, relapses, or even stable plateaus. There is no effective drug therapy for ALS, although riluzole has been shown to prolong life in sufferers, without tracheostomy. A vitamin B12 analog, methylcobalamin, has a protective effect on cultured cortical neurons against glutamate-induced cytotoxicity. We have shown the ultra-high-dose methylcobalamin (25 mg/day i.m.) slows down the progressive reduction of the CMAP (compound muscle action potential) amplitudes in ALS in the short term (4 weeks). The latencies of SSR (sympathetic skin response) were shorter after treatment (50 mg/day i.v., 2 weeks). In the long-term effect of methylcobalamin (50 mg/day i.m., twice a week), the survival time (or the period to become respirator-bound) was significantly longer in the treated group than in the untreated. Larger-scale randomized double blind trial was started in Japan in order to evaluate the long-term efficacy and the safety of ultra-high-dose methylcobalamin for sporadic or familial cases of ALS.

The Wikipedia definition can be found at the Methylcobalamin link.
Thirty scientific paper Abstracts on Methylcobalamin from the years 1984-2000 discuss the apparent benefits of methylcobalamin for ALS, MS, diabetic neuropathy and other neurodegenerative disorders and conditions.       


If you decide to have daily intramuscular injections of 25 mg/day of methylcobalamin, please do consider the following: Avoid alcohol and smoking; If antibiotics are needed methylcobalamin should be temporarily discontinued; Do not use if you are diabetic.  Discuss in detail with your physician before beginning this protocol.


Inhjectible Methylcobalamin can be obtained with a physicians prescription from Hopewell Pharmaceutical, Hopewell, New Jersey. (See prescription form for details). Prescription form

The long-term (2007-2014) clinical trial of methylcobalamin for those with ALS being conducted in Japan can be found at Clinical Trials.Gov 

The NIH (National Institutes of Health) identifies methylcobalamin as one of only four Phase III pharmaceuticals currently in trial for ALS (as of April, 2010). Prior safety and dosage tests of ultra-high dosage IM injectable methylcobalamin demonstrated benefit after approximately 30 days. 

If you or your physician have any quesitons or would like to discuss our viewpoints regarding methylcobalamin, please email us at [email protected]



Because we now serve the ALS community in over 70 countries, many of them Spanish speaking societies, the need for our written materials to be available in Spanish has never been more important.  Persons with ALS in Spain, Colombia, Argentina, Peru, Ecuador, Mexico, Honduras, Costa Rica, Chile, Uruguay, Venezuela, Puerto Rico, United States and other locales regularly request information about our efforts in their own language.  The Methylcobalamin materials have been translated into Spanish and are now available.

Informacion General

Forma de Receta General

Perfil de Participante

Informacion de Paciente de Inyecciones Intramusculares

Reporte de Estado Basal


ALS WORLDWIDE does not offer or purport to offer medical advice to patients or their families.

Recommendations and suggestions are intended to minimize symptoms, improve the quality of life and should be discussed with family, caregivers, neurologists, other physicians and support groups.